Gender reassignment requires a holistic approach
Bruce Jenner’s journey is shining a light on a transformative surgery that he will reportedly discuss Friday during an interview with Diane Sawyer.
Gender confirmation is the process of changing one’s genetic sex. Those who perform the surgery and the team providing emotional and spiritual support say the decision to have the operation is often difficult and one that requires support for the whole person – mind, body and spirit.
Dr. Loren S. Schechter, a plastic surgeon at Advocate Lutheran General Hospital in Park Ridge, Ill., is one of the few plastic surgeons in the world who performs gender confirmation surgeries.
He offers some insight about the comprehensive approach used when changing genetic sex.
What is the gender confirmation process?
The World Professional Association for Transgender Health has created internationally-accepted standards of care to provide guidance for transsexual, transgender and gender-nonconforming people, as well as their health professionals.
Dr. Schechter, who helped write the guidelines, says that an individual who is considering gender confirmation surgery needs to go through a very defined process that includes a mental health evaluation, counseling, therapy and living in the opposite sex for a certain period of time.
“People typically live for at least a year or two in the opposite sex before they have the surgery. Most people have been living this way ever since they can remember,” says Dr. Schechter. “The process is not complex, it just takes some time. Surgery is the final and most dramatic step in the gender confirmation journey, and we want to make sure that people are completely ready before we perform the surgery.”
Is gender confirmation surgery on the rise?
Dr. Schechter says he’s been seeing more and more cases in the past few years.
“This has become more mainstream with all the media attention on this topic in the past few years,” he says. “Attitudes are slowly changing.”
Dr. Schechter says that statistics show that one in every 12,000 genetic males and one in 100,000 genetic females are transgender individuals.
“In the past, we were seeing more male to female transformations, but female to male surgery is on the rise,” he says.
Another reason for the increased number of surgeries is that most insurance companies now cover this type of surgery.
“The cost of the surgery was a big obstacle in the past, and now that the surgery is covered by insurance, people don’t need to travel oversees to Thailand and other countries to get the surgery done,” Dr. Schechter says. “They can have it done in a safe and reliable fashion here in the U.S.”
Since there is only a handful of surgeons in the world who do this kind of surgery, Dr. Schechter sees patients from around the world. His patients come from throughout the U.S., Canada, South America and Australia.
Emotional and spiritual support
This transformation requires more than just surgery. Caregivers also focus on providing patients with the emotional and spiritual support they need to transition back to everyday life.
“In caring for these patients, as in caring for all patients, we look at the needs of the whole person,” says the Rev. Kevin Massey, vice president of Mission and Spiritual Care at Lutheran General Hospital. “When someone has reached the point of having this surgery, they are nearing the conclusion of a lifelong struggle. They have spent their lives feeling like they are not the person they want to be. It has caused them great distress.”
Because individuals can feel confusion, sadness and depression, Massey says it is essential to provide mental health and spiritual support.
“For many, this has been a very long and profound journey,” Massey says. “Being treated with dignity, respect and admiration for the courage they have shown is critical in the recovery process after surgery and well beyond.”
Related Posts
Comments
31 Comments
About the Author
Sonja Vojcic, health enews contributor, is a marketing manager at Advocate Health Care in Downers Grove, Ill. She has several years of international public relations and marketing experience with a Master’s degree in Communications from DePaul University. In her free time, Sonja enjoys spending time with her family, travelling, and keeping up with the latest health news and fashion trends.
I’m thrilled to see such a positive article on the topic of gender confirmation surgery and transgender health. Thank you for taking on this topic.
I agree with you! Glad the world is finally making a great turn !
I find this topic – coming from a Christian based organization – disheartening & disappointing!
Thank you for gently and compassionately discussing this topic. I am proud to work for an organization that can treat all individuals without bias or judgment. Let us just love and support each other as we walk through this life.
I find this topic coming from a Christian based organization refreshing! Love the sinner (as we all are) and hate the SIN!
While this topic is confusing to most of us, unless you have walked in a transgenders shoes you can’t understand what that person is going through. I’m glad that our hospital is not judging but supporting these individuals.
Just because you don’t or won’t partake in something does not mean that you judge it. It takes more to be a woman than hormone shots and plastic surgery. Real women have real women issues that help to shape and define us not only as individuals, but a uniquely gendered species. Personally, I find it offensive and degrading for someone to really think and believe that all it takes to be a woman is some hormone shots, plastic surgery and therapy. Try getting pregnant, better yet have the worry that if you are sexually assaulted you could become pregnant – that is a real worry that women have. Also try being discriminated against on the employment front by making 76 cents for every dollar a man makes for the same position and sometimes better education and credentials . I ask MR. Jenner; does he think he would have had an easy time being a triathlete as a woman? During this time would he even have been allowed to be considered a viable contender – probably not. Women in sports allowed to excel during this decade were few and far between; especially in the area of track and field. Let’s try something a little more basic – How about a menstrual cycle; being truly afraid of having the embarrassment of getting up from a chair to have a large maroon stain on your back-side. The world has gotten to the point where anything you are not satisfied with have surgery or take a pill and change it. Some things people just have to deal with or work viably to change it …..period, there’s no App for that!! Changing the outside and what people see, still does not change the inside and make it the truth.
You are missing the point. He has felt like a woman on the inside his entire life, and is trying to change the outside to match the inside. As people who are in sync with our genders inside and out, we cannot begin to feel what these people feel. Yes, those physical things are part of what makes us women, but there are plenty of things on the inside that matter, too.
“He has felt like a woman on the inside his entire life”, yet abused the privilege of marriage TWICE! AND fathered children. How is it that he is allowing this “feeling” to come out at 65 years old?
Susan- as a Christian- one who believes in the teachings of Jesus Christ, I’m a very firm believer in Matthew 7:1-5. If you don’t feel your comment justfies Matthew, then please read James 4:12.
I’m happy to see that people who’ve suffered their entire lives feeling that they don’t belong, now have the option to try and live a happy life.
I’m a clinician working with transgendered youth and adults. I am looking for endocrinologists who can provide hormone therapy for my clients. Can you help me connect with some doctors in the Advocate group?
Susan, please contact the office of Dr. Loren Schechter at 847.967.5122 and they can give you the names of a few primary care and/or endocrinologists who provide hormone therapy.
Thank you for gently and compassionately discussing this topic. I am proud to work for an organization that can treat all individuals without bias or judgment. Let us just love and support each other as we walk through this life.
I’ve mostly thought that elective surgery was to be very thoroughly thought, considered, prayed about. it is disappointing to me that when you have the money, this is an option. I know a young girl who considers herself a boy and behaves, dresses as such. no surgery.
my opinion – I find it shocking. I am not judging the person for wanting to change their gender, I am disappointed at what money can buy these days.
I’m glad that this is no longer ABOUT money; it is being covered by insurance as stated in the article. It is heartening to me that people who feel this way can make this final step, if they wish (and not all do) to be the people they feel they are on the inside.
I find this article fascinating. As a woman I can’t imagine being a man. So I know I’m the right gender. I want to see the interview to gain insight. I once worked with a man who became a woman. I felt for him because, at the time, being a transgender was not acceptable nor understood. He was practically ostrichized among his co-workers. I know it was a painful and difficult time for him. No one would deliberately want to go through this transition unless they felt emotionally and physicially compelled to do so.
It’s time we stop defining medical issues as faith based concerns. Gender reassignment comes from a medical need, please don’t limit others health needs based on your beliefs.
Sorry to be the bearer of news, but medical issues are faith based – More prayer occurs in a hospital (and schools) almost more than any other place outside a place of worship. Medicine and Faith go hand in hand.. period.
It goes hand in hand for you and many other people, but not everyone.
I disagree. Medicine and science go hand in hand. Faith is an entirely different matter. Prayer may happen in these places to give people solace, but it is the science that defines medicine. When faith tried to define medicine, they burned people at the stake for disagreeing.
Why is Advocate writing this? Why does the CEO talk about our Christian Ministry and offer a prayer before meetings, but then the corporation heads in this direction? I understand we want to be “progressive” and earn market penetration (be popular), but why gain the world when you lose your soul? Is everything about profits? If that’s the world’s philosophy, then what will our future look like? Do cosmetic surgeons really believe this is a good practice, or is it really about making busines$? Is the person a patient, or an opportunity? If you turn down one of these people and the news gets ahold of it and labels you intolerant and full of hate, will your job and image end there? Perhaps. However, is there a power higher than being liked on Facebook, currency in your hand, and a nice 401k? I believe so.
The bottom line is, is there a right and wrong in the world? Is anything absolute, or are all norms and mores changeable. Really? All social mores are changeable? Nothing is rooted into a stable foundation? How do we construct a society then? And if all mores and changeable, what else will change in future society? What laws will be re-written by the children of today who are growing up in an “alternative lifestyle” world? Do you really believe all change leans towards good?
Would the female members in the Advocate fitness center be okay with Bruce Jenner using their locker room to change and shower and steam in? Well, ask them. (No, I don’t mean on the Internet.) My guess is they would feel very uncomfortable. Surely, Mr. Jenner would feel uncomfortable in the men’s room and I should respect his feelings as well. However, he was the one who changed his gender. He made the move.
Some people like a normal, conservative place to be born, live, and die in. Perhaps these individuals will make up the minority in the future years. A minority though, that no one will march with, no one will televise, no one will report on, no one will sing songs about, and no one will hire for a job. The world will hate them for believing in (scriptural) God. The only songs about them will mock them. Let it be so.
There are lots of reasons a human being is depressed. Being identified as the wrong gender is not the root of why someone is depressed. If it was, I would like to meet him/her today, and observe their happiness today that they didn’t have before.
There is no medical issue here. It’s the same for insurance paying for condoms. Not engaging in sexual activities does not medically harm you. There’s no reason for healthcare to be involved. Harming yourself because you want a change of gender is not related to medical insurance paying for you to have a surgery to remove, or put on, something that was never there, and is not doing you any physical harm if it remains.
If one is losing their hair, should insurance pay for plugs? What if the person threaten suicide over it because the depression is too much? Then do they pay? Do they pay for crooked teeth and braces? What happens if someone is the wrong race? How much is the cost for skin color re-assignment? What if someone is the wrong age? This person believes they are older, while this one believes they are younger. Can we change their date of birth and their licenses to reflect who they are really?
Someone once tried to sell me a banana. I looked at the individual and said, “Why did you take an orange and paint it yellow? It’s an orange.” They looked at me with great offense, and said I was stupid, “No, it’s a banana. Can’t you see how it’s yellow?”
“Yes I can see that, but it’s still an orange.”
To any dissenters of this article, don’t let others make you think your reading of the Bible is incorrect. There are other people like you and I out there who do not believe the changes in our global society are positive. Often, the dissenter’s opinion is also the opinion of a meek person. However quiet they are, they know where their beliefs lie. Also, the Internet-medium itself is more frequently used by like-minded, “progressive,” technological people. There are a whole lot of people not able to reply to this article. I may see a lot of commenters accepting this article and what it preaches, but there are a lot of other people out there who aren’t using the Internet like this. Some are too busy, or some don’t care. However, if you forced an opinion out of them, you would not find as many positive comments as is listed here. The Internet will never do a good job at showing national/global polling data.
My opinion is not alone, nor is it bigoted. I have been through scenarios of living with, working with, and driving with homosexual men, transgenders, or other alternative lifestyle individuals. I have no fear of them. I feel related to them and their past ostracism by society. Never did I refuse their conversation or assistance. I liked getting to know them. I hung out with them, I got to know their musical talents and sense of humor, and others’, their pain and hurt. I even bought them food as a roommate. Never though, will I encourage their choice as a positive change in society. Never did I agree to them that their lifestyle was a positive force. Never did they dismiss me as a bigot to my face. Never did I think I was head and heels above them as if my sinful ways were somehow less bad than theirs.
Ryan,
I understand your beliefs, but your opinion is bigoted. Until that is understood, no progress can be made with those who think like this.
God does not progress, nature does not progress. God is the same from the beginning to the end.
Nature simply lives as it was created from the start. There is no surgery, but only a process of life, survival, and death. Nature makes the best of what it innately has already. Nature changes, surely, but it changes in cycles, or the change is something it already has inside itself and does not need an intervention to make it come about.
Though Jenner was before my time, he sounds like he was a man who made the most of his natural, physical talents. However, now he is going against his innate abilities and functions to something that was never given to him to have.
The word bigot loses its meaning the more I hear it, like the word “love” in a sexual pop song. All I have to do is visit another state, country, or continent and I can know there are lots of various, up-standing people who profess a similar belief as mine. I’m not after trying to find support for my opinion, though. I want the truth. If someday I find the truth to show this as a positive change, I can accept it. However, I feel this is not a positive way to live. Don’t mistake me, I have the same attitude towards many “traditional” activities people, or even myself, partake in today that are not positive.
“Never did I refuse their conversation or assistance. I liked getting to know them. I hung out with them, I got to know their musical talents and sense of humor, and others’, their pain and hurt. I even bought them food as a roommate.”
So you treated them with respect as you would any other human being? Congrats! That’s what it is all about.
“Never though, will I encourage their choice as a positive change in society. Never did I agree to them that their lifestyle was a positive force. Never did they dismiss me as a bigot to my face. Never did I think I was head and heels above them as if my sinful ways were somehow less bad than theirs.”
This, however, is not tolerance. This is covert bigotry, perhaps because you assume that being born in the wrong gender is a choice. If you are truly seeking to understand these differences (and I would hope that you are, since loving all is pretty much the main message of Christian Ministry, no?), I suggest you research the following terms and pray on them: “empathy” “tolerance” “cis-gendered privilege”
These things are not new, not different. The difference is us, as a society. We have grown and changed, to understand that it our alikeness that matters, more than our differences. The Bible is but one book in the library, and many of us do not codify others through its pages. Condoms are part of healthcare, if they give men and women reproductive choice. Yes, for many of us, this IS positive change.
So happy to see that this is happening at Advocate. That a faith based organization is truely Loving all as Jesus would.
GOP policies,opinions, have spoken against
transgenders. I do not understand how a person goes from female to male or vice versa. Drastic surgery to change gender is huge, taking hormones for life must do some
damage I am very confused.
One of my adult children is transgender. I can see a positive difference in happiness and behaviors. I worry about the treatment my child might receive by people who are so bigoted, negative and judgmental. That’s the terrible shame.
Thank you for sharing this article and promoting tolerance and diversity within our system. Transgender people want to pursue happiness just like cis-gender (non-trans) people.
“Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing?” Matthew 6:25
I didn’t realize most people live for a year or two in the opposite sex before having confirmation surgery. It seems like that would help them be able to make the transition much more easily after their surgery than just doing everything all at once. Thanks for a great article about such a sensitive topic. I feel like this article will help a lot of people!